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Organization
SUPER HOME CARE LLC
Active
Organization
SUPER HOME CARE LLC
Active
Other names
super home care llc
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED ELIAS OMER (OWNER -MANAGER)
(720) 829-9083
Entity
Organization
Contact information
Practice address
1230 S PARKER RD STE 217, 1230 S PARKER RD STE 217, DENVER, CO 80231-2119
(303) 728-9154
(303) 728-9154
Mailing address
1230 S PARKER RD STE 217, 1230 S PARKER RD STE 217, DENVER, CO 80231-2119
(303) 728-9154
(303) 728-9154
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112440310
HOMEMAKER CES/SLS
CO
Enumeration date
05/21/2020
Last updated
04/14/2021
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